By Tami Luhby, NCS
The Centers for Medicare and Medicaid Services introduced Wednesday that it’s putting a six-month moratorium on new enrollment of health suppliers in Medicare — its newest effort to fight what it says is widespread fraud amongst hospice and home health suppliers.
“We’ve seen systemic and deeply troubling fraud in the hospice and home health space, with bad actors exploiting some of our most vulnerable Medicare patients and stealing money from the American taxpayer,” CMS Administrator Dr. Mehmet Oz stated in a press release.
“Today we’re shutting the door on fraud—preventing new bad actors from entering Medicare while we aggressively identify, investigate, and remove those already exploiting them.”
Oz, who’s working with Vice President JD Vance’s Anti-Fraud Task Force, has made combatting fraud a prime precedence. The two are set to make a fraud-related announcement on Wednesday afternoon.
Vance can be touring to Maine on Thursday to debate the administration’s anti-fraud efforts, which have focused the state. President Donald Trump referenced Maine as a hotbed of fraud in his State of the Union tackle in February.
Maine’s Senate race, the place GOP Sen. Susan Collins is operating for a sixth time period, is predicted to be among the many best of the November midterm election.
In addition to pausing Medicaid payments to Minnesota earlier this 12 months, Oz has filmed movies and despatched letters to governors in search of data and demanding they craft plans to enhance the integrity of their packages and revalidate suppliers.
In February, Oz despatched a letter to Maine Gov. Janet Mills, a Democrat, citing considerations in regards to the state’s Medicaid-funded therapy program for youngsters with autism and demanding details about what the state is doing to determine and stop fraud, in addition to to get better stolen or misspent funds. Mills known as the trouble a “political attack.”
CMS additionally positioned the same six-month nationwide moratorium on sure firms that present sturdy medical gear, equivalent to wheelchairs, hospital beds and oxygen gear — an trade it says can be rife with fraud.
The administrator has centered his hospice anti-fraud efforts in the Los Angeles space. CMS says it has suspended $70 million funds to 773 hospices and 23 home health companies suspected of fraud in town.
CMS has additionally revoked or deactivated tons of of hospices and home health companies it says engaged in fraud or improper exercise; elevated oversight of new hospice suppliers in Arizona, California, Georgia, Ohio, Nevada and Texas; expanded critiques of home health company claims in Florida, Illinois, Oklahoma, Ohio, North Carolina and Texas; and carried out hospice website visits.
However, the new moratorium might damage official suppliers of hospice companies and restrict sufferers’ entry to care, the National Alliance for Care at Home stated in a press release.
“An enrollment moratorium raises serious access-to-care concerns in areas where patient demand is growing or existing capacity is already strained, leading to longer wait times, reduced service availability, and fewer choices for patients – particularly in rural or underserved communities,” the alliance stated.
The group added it and different nationwide organizations have supplied CMS with suggestions and focused methods for stopping dangerous actors from coming into Medicare and Medicaid, whereas not overly burdening good-faith suppliers.
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